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exactly what the title says.. I have a job site and the spammers are driving me nuts registering, I need some sort of image verification to add to the form
here is the code
<?
include_once "../main.php";
?>
<script language="JavaScript">
function chk()
{
if (document.form.uname.value=='')
{
alert("Please enter name");
document.form.uname.focus();
return false;
}
if (document.form.upass.value=='')
{
alert("Please enter password");
document.form.upass.focus();
return false;
}
if (document.form.cpass.value=='')
{
alert("Please enter password");
document.form.cpass.focus();
return false;
}
if (document.form.upass.value != document.form.cpass.value)
{
alert("Passwords donot match");
document.form.upass.focus();
return false;
}
if (document.form.title.value=='')
{
alert("Please select title");
document.form.title.focus();
return false;
}
if (document.form.fname.value=='')
{
alert("Please enter first name");
document.form.fname.focus();
return false;
}
if (document.form.lname.value=='')
{
alert("Please enter last name");
document.form.lname.focus();
return false;
}
if (document.form.bmonth.value=='')
{
alert("Please select month name");
document.form.bmonth.focus();
return false;
}
if (document.form.bday.value=='')
{
alert("Please select day");
document.form.bday.focus();
return false;
}
if (document.form.byear.value=='')
{
alert("Please select year");
document.form.byear.focus();
return false;
}
if (document.form.city.value=='')
{
alert("Please enter city name");
document.form.city.focus();
return false;
}
if (document.form.country.value=='')
{
alert("Please select country");
document.form.country.focus();
return false;
}
if (document.form.zip.value=='')
{
alert("Please enter zip code");
document.form.zip.focus();
return false;
}
if (document.form.address.value=='')
{
alert("Please enter address");
document.form.address.focus();
return false;
}
if (document.form.phone.value=='')
{
alert("Please enter phone");
document.form.phone.focus();
return false;
}
if (document.form.job_seeker_email.value=='')
{
alert("Please enter email addreess");
document.form.job_seeker_email.focus();
return false;
}
if (document.form.careerlevel.value=='')
{
alert("Please select career level");
document.form.careerlevel.focus();
return false;
}
if (/^\w+([\.-]?\w+)*@\w+([\.-]?\w+)*(\.\w{2,3})+$/.test(form.job_seeker_email.value))
{
return (true)
}
else
{
alert("Invalid E-mail Address! Please re-enter.")
document.form.job_seeker_email.focus()
return (false)
}
return true;
}
</script>
<form action=jobseeker_registration2.php method=post name="form" onSubmit="return chk();">
<table align=center width=590 cellspacing=0 cellpadding="3">
<tr>
<td>
Username:<font color=red>*</font>
</td>
<td>
<input type=text name=uname size=23 maxlength=10><br> <font size=1>max. 10 symbols (letters and/or numbers) </font>
</td>
</tr>
<tr>
<td>
Password:<font color=red>*</font>
</td>
<td>
<input type=password name=upass size=23 maxlength=10><br> <font size=1>max. 10 symbols (letters and/or numbers) </font>
</td>
</tr>
<tr>
<td>
Confirm password:<font color=red>*</font>
</td>
<td>
<input type=password name=cpass size=23 maxlength=10>
</td>
</tr>
<tr>
<td>
Titile:<font color=red>*</font>
</td>
<td>
<select name=title>
<option value=""> </option>
<option value="Mr.">Mr. </option>
<option value="Ms.">Ms. </option>
</select>
</td>
</tr>
<tr>
<td>
First name:<font color=red>*</font>
</td>
<td>
<input type=text name=fname size=23>
</td>
</tr>
<tr>
<td>
Last name:<font color=red>*</font>
</td>
<td>
<input type=text name=lname size=23>
</td>
</tr>
<tr>
<td>
Date of birth: <font color=red>*</font>
</td>
<td>
<select name=bmonth>
<option value=""> Month </option>
<option value=1> January </option>
<option value=2> February </option>
<option value=3> March </option>
<option value=4> April </option>
<option value=5> May </option>
<option value=6> June </option>
<option value=7> July </option>
<option value=8> August </option>
<option value=9> September </option>
<option value=10> October </option>
<option value=11> November </option>
<option value=12> December </option>
</select>
<select name=bday>
<option value=""> Day </option>
<option value=1> 1 </option>
<option value=2> 2 </option>
<option value=3> 3 </option>
<option value=4> 4 </option>
<option value=5> 5 </option>
<option value=6> 6 </option>
<option value=7> 7 </option>
<option value=8> 8 </option>
<option value=9> 9 </option>
<option value=10> 10 </option>
<option value=11> 11 </option>
<option value=12> 12 </option>
<option value=13> 13 </option>
<option value=14> 14 </option>
<option value=15> 15 </option>
<option value=16> 16 </option>
<option value=17> 17 </option>
<option value=18> 18 </option>
<option value=19> 19 </option>
<option value=20> 20 </option>
<option value=21> 21 </option>
<option value=22> 22 </option>
<option value=23> 23 </option>
<option value=24> 24 </option>
<option value=25> 25 </option>
<option value=26> 26 </option>
<option value=27> 27 </option>
<option value=28> 28 </option>
<option value=29> 29 </option>
<option value=30> 30 </option>
<option value=31> 31 </option>
</select>
<select name=byear>
<option value=""> Year </option>
<option value=1986> 1986 </option>
<option value=1985> 1985 </option>
<option value=1984> 1984 </option>
<option value=1983> 1983 </option>
<option value=1982> 1982 </option>
<option value=1981> 1981 </option>
<option value=1980> 1980 </option>
<option value=1979> 1979 </option>
<option value=1978> 1978 </option>
<option value=1977> 1977 </option>
<option value=1976> 1976 </option>
<option value=1975> 1975 </option>
<option value=1974> 1974 </option>
<option value=1973> 1973 </option>
<option value=1972> 1972 </option>
<option value=1971> 1971 </option>
<option value=1970> 1970 </option>
<option value=1969> 1969 </option>
<option value=1968> 1968 </option>
<option value=1967> 1967 </option>
<option value=1966> 1966 </option>
<option value=1965> 1965 </option>
<option value=1964> 1964 </option>
<option value=1963> 1963 </option>
<option value=1962> 1962 </option>
<option value=1961> 1961 </option>
<option value=1960> 1960 </option>
<option value=1959> 1959 </option>
<option value=1958> 1958 </option>
<option value=1957> 1957 </option>
<option value=1956> 1956 </option>
<option value=1955> 1955 </option>
<option value=1954> 1954 </option>
<option value=1953> 1953 </option>
<option value=1952> 1952 </option>
<option value=1951> 1951 </option>
<option value=1950> 1950 </option>
<option value=1949> 1949 </option>
<option value=1948> 1948 </option>
<option value=1947> 1947 </option>
<option value=1946> 1946 </option>
<option value=1945> 1945 </option>
<option value=1943> 1943 </option>
<option value=1942> 1942 </option>
<option value=1941> 1941 </option>
<option value=1940> 1940 </option>
<option value=1939> 1939 </option>
<option value=1938> 1938 </option>
<option value=1937> 1937 </option>
<option value=1936> 1936 </option>
<option value=1935> 1935 </option>
<option value=1934> 1934 </option>
<option value=1933> 1933 </option>
<option value=1932> 1932 </option>
</select>
</td>
</tr>
<tr>
<td>
Marital Status:
</td>
<td>
<SELECT NAME="maritalstatus">
<OPTION VALUE="Domestic Partner">Domestic Partner</OPTION>
<OPTION VALUE="Engaged">Engaged</OPTION>
<OPTION VALUE="Married">Married</OPTION>
<OPTION VALUE="Separated/Divorced">Separated/Divorced</OPTION>
<OPTION VALUE="Single" selected>Single</OPTION>
<OPTION VALUE="Widowed">Widowed</OPTION>
</SELECT>
</td>
</tr>
<tr>
<td>
Household Income:
</td>
<td>
<SELECT NAME="income" style=width:149>
<OPTION VALUE="1">Under $15,000</OPTION>
<OPTION VALUE="2" selected>$15,000-$29,999</OPTION>
<OPTION VALUE="3">$30,000-$49,999</OPTION>
<OPTION VALUE="4">$50,000 - 74,999</OPTION>
<OPTION VALUE="5">$75,000 - 99,999</OPTION>
<OPTION VALUE="6">$100,000 - 149,999</OPTION>
<OPTION VALUE="7">$150,000 and over</OPTION>
</SELECT>
</td>
</tr>
<tr>
<td>
City:<font color=red>*</font>
</td>
<td>
<input type=text name=city size=33>
</td>
</tr>
<tr>
<td>
State:
</td>
<td>
<select name=state style=width:154>
<OPTION VALUE="Not in US">Not in US</OPTION>
<OPTION VALUE="Alabama">Alabama</OPTION>
<OPTION VALUE="Alaska">Alaska</OPTION>
<OPTION VALUE="Arizona">Arizona</OPTION>
<OPTION VALUE="Arkansas">Arkansas</OPTION>
<OPTION VALUE="California">California</OPTION>
<OPTION VALUE="Colorado">Colorado</OPTION>
<OPTION VALUE="Connecticut">Connecticut</OPTION>
<OPTION VALUE="Delaware">Delaware</OPTION>
<OPTION VALUE="District of Columbia">District of Columbia</OPTION>
<OPTION VALUE="Florida">Florida</OPTION>
<OPTION VALUE="Georgia">Georgia</OPTION>
<OPTION VALUE="Hawaii">Hawaii</OPTION>
<OPTION VALUE="Idaho">Idaho</OPTION>
<OPTION VALUE="Illinois">Illinois</OPTION>
<OPTION VALUE="Indiana">Indiana</OPTION>
<OPTION VALUE="Iowa">Iowa</OPTION>
<OPTION VALUE="Kansas">Kansas</OPTION>
<OPTION VALUE="Kentucky">Kentucky</OPTION>
<OPTION VALUE="Louisiana">Louisiana</OPTION>
<OPTION VALUE="Maine">Maine</OPTION>
<OPTION VALUE="Maryland">Maryland</OPTION>
<OPTION VALUE="Massachusetts">Massachusetts</OPTION>
<OPTION VALUE="Michigan">Michigan</OPTION>
<OPTION VALUE="Minnesota">Minnesota</OPTION>
<OPTION VALUE="Mississippi">Mississippi</OPTION>
<OPTION VALUE="Missouri">Missouri</OPTION>
<OPTION VALUE="Montana">Montana</OPTION>
<OPTION VALUE="Nebraska">Nebraska</OPTION>
<OPTION VALUE="Nevada">Nevada</OPTION>
<OPTION VALUE="New Hampshire">New Hampshire</OPTION>
<OPTION VALUE="New Jersey">New Jersey</OPTION>
<OPTION VALUE="New Mexico">New Mexico</OPTION>
<OPTION VALUE="New York">New York</OPTION>
<OPTION VALUE="North Carolina">North Carolina</OPTION>
<OPTION VALUE="North Dakota">North Dakota</OPTION>
<OPTION VALUE="Ohio">Ohio</OPTION>
<OPTION VALUE="Oklahoma">Oklahoma</OPTION>
<OPTION VALUE="Oregon">Oregon</OPTION>
<OPTION VALUE="Pennsylvania">Pennsylvania</OPTION>
<OPTION VALUE="Puerto Rico">Puerto Rico</OPTION>
<OPTION VALUE="Rhode Island">Rhode Island</OPTION>
<OPTION VALUE="South Carolina">South Carolina</OPTION>
<OPTION VALUE="South Dakota">South Dakota</OPTION>
<OPTION VALUE="Tennessee">Tennessee</OPTION>
<OPTION VALUE="Texas">Texas</OPTION>
<OPTION VALUE="Utah">Utah</OPTION>
<OPTION VALUE="Vermont">Vermont</OPTION>
<OPTION VALUE="Virgin Islands">Virgin Islands</OPTION>
<OPTION VALUE="Virginia">Virginia</OPTION>
<OPTION VALUE="Washington">Washington</OPTION>
<OPTION VALUE="West Virginia">West Virginia</OPTION>
<OPTION VALUE="Wisconsin">Wisconsin</OPTION>
<OPTION VALUE="Wyoming">Wyoming</OPTION>
</select>
</td>
</tr>
<tr>
<td>
Country:<font color=red>*</font>
</td>
<td>
<select name=country>
<OPTION VALUE="">Select</OPTION>
<OPTION VALUE="USA">USA</OPTION>
<OPTION VALUE="Canada">Canada</OPTION>
<OPTION VALUE="UK">UK</OPTION>
</select>
</td>
</tr>
<tr>
<td>
Zip:<font color=red>*</font>
</td>
<td>
<input type=text name=zip size=7>
</td>
</tr>
<tr>
<td>
Address:<font color=red>*</font>
</td>
<td>
<input type=text name=address>
</td>
</tr>
<tr>
<td>
Phone:<font color=red>*</font>
</td>
<td>
<input type=text name=phone>
</td>
</tr>
<tr>
<td>
Phone #2:
</td>
<td>
<input type=text name=phone2>
</td>
</tr>
<tr>
<td>
Email:<font color=red>*</font>
</td>
<td>
<input type=text name=job_seeker_email>
</td>
</tr>
<tr>
<td valign=top>
Job Category:<font color=red>*</font> <br>
</td>
<td valign=top>
<SELECT NAME="JobCategory">
<OPTION VALUE="Trucking Jobs">Trucking Jobs</OPTION>
<OPTION VALUE="Dock Workers">Dock Workers</OPTION>
<OPTION VALUE="LTL Jobs">LTL Jobs</OPTION>
<OPTION VALUE="OTR Jobs">OTR Jobs</OPTION>
<OPTION VALUE="Tanker Jobs">Tanker Jobs</OPTION>
<OPTION VALUE="Dedicated Jobs">Dedicated Jobs</OPTION>
<OPTION VALUE="Regional Jobs">Regional Jobs</OPTION>
<OPTION VALUE="Office Jobs">Office Jobs</OPTION>
<OPTION VALUE="Management Jobs">Management Jobs</OPTION>
<OPTION VALUE="Other Jobs">Other Jobs</OPTION>
<OPTION VALUE="F">Transportation and Warehousing</OPTION>
</SELECT><br>
</td>
</tr>
<tr>
<td>
Your career level:<font color=red>*</font>
</td>
<td>
<select name="careerlevel">
<option value=""> </option>
<OPTION VALUE="1">Student (High School)</OPTION>
<OPTION VALUE="2">Student (undergraduate/graduate)</OPTION>
<OPTION VALUE="3">Entry Level (less than 2 years of experience)</OPTION>
<OPTION VALUE="4">Mid Career (2+ years of experience)</OPTION>
<OPTION VALUE="5">Management (Manager/Director of Staff)</OPTION>
<OPTION VALUE="6">Executive (SVP, EVP, VP)</OPTION>
<OPTION VALUE="7">Senior Executive (President, CEO)</OPTION>
</select>
</td>
</tr>
<tr>
<td>
Target company:
</td>
<td>
<select name="target_company">
<option value=""> </option>
<option value="Small (up to 99 empl.)"> Small (up to 99 empl.) </option>
<option value="Medium (100 - 500 empl.)"> Medium (100 - 500 empl.) </option>
<option value="Large (over 500 empl.)"> Large (over 500 empl.) </option>
</select>
</td>
</tr>
<tr>
<td valign=top>
Willing to relocate?
</td>
<td>
<input type=radio name=relocate value=Yes checked>Yes<br>
<input type=radio name=relocate value=No>No
</td>
</tr>
<tr>
<td align=left>ย </td>
<td align=center>
<input class=s2 type=submit name=submit value="Register me" align=left>
<input class=s2 type=reset name=reset value="Reset" align=right>
</td>
</tr>
</table>
</form>
<? include_once('../foother.html'); ?>
oh, I don't expect this to be done for free but I do expect it to be done right.
Thanks
here is the code
<?
include_once "../main.php";
?>
<script language="JavaScript">
function chk()
{
if (document.form.uname.value=='')
{
alert("Please enter name");
document.form.uname.focus();
return false;
}
if (document.form.upass.value=='')
{
alert("Please enter password");
document.form.upass.focus();
return false;
}
if (document.form.cpass.value=='')
{
alert("Please enter password");
document.form.cpass.focus();
return false;
}
if (document.form.upass.value != document.form.cpass.value)
{
alert("Passwords donot match");
document.form.upass.focus();
return false;
}
if (document.form.title.value=='')
{
alert("Please select title");
document.form.title.focus();
return false;
}
if (document.form.fname.value=='')
{
alert("Please enter first name");
document.form.fname.focus();
return false;
}
if (document.form.lname.value=='')
{
alert("Please enter last name");
document.form.lname.focus();
return false;
}
if (document.form.bmonth.value=='')
{
alert("Please select month name");
document.form.bmonth.focus();
return false;
}
if (document.form.bday.value=='')
{
alert("Please select day");
document.form.bday.focus();
return false;
}
if (document.form.byear.value=='')
{
alert("Please select year");
document.form.byear.focus();
return false;
}
if (document.form.city.value=='')
{
alert("Please enter city name");
document.form.city.focus();
return false;
}
if (document.form.country.value=='')
{
alert("Please select country");
document.form.country.focus();
return false;
}
if (document.form.zip.value=='')
{
alert("Please enter zip code");
document.form.zip.focus();
return false;
}
if (document.form.address.value=='')
{
alert("Please enter address");
document.form.address.focus();
return false;
}
if (document.form.phone.value=='')
{
alert("Please enter phone");
document.form.phone.focus();
return false;
}
if (document.form.job_seeker_email.value=='')
{
alert("Please enter email addreess");
document.form.job_seeker_email.focus();
return false;
}
if (document.form.careerlevel.value=='')
{
alert("Please select career level");
document.form.careerlevel.focus();
return false;
}
if (/^\w+([\.-]?\w+)*@\w+([\.-]?\w+)*(\.\w{2,3})+$/.test(form.job_seeker_email.value))
{
return (true)
}
else
{
alert("Invalid E-mail Address! Please re-enter.")
document.form.job_seeker_email.focus()
return (false)
}
return true;
}
</script>
<form action=jobseeker_registration2.php method=post name="form" onSubmit="return chk();">
<table align=center width=590 cellspacing=0 cellpadding="3">
<tr>
<td>
Username:<font color=red>*</font>
</td>
<td>
<input type=text name=uname size=23 maxlength=10><br> <font size=1>max. 10 symbols (letters and/or numbers) </font>
</td>
</tr>
<tr>
<td>
Password:<font color=red>*</font>
</td>
<td>
<input type=password name=upass size=23 maxlength=10><br> <font size=1>max. 10 symbols (letters and/or numbers) </font>
</td>
</tr>
<tr>
<td>
Confirm password:<font color=red>*</font>
</td>
<td>
<input type=password name=cpass size=23 maxlength=10>
</td>
</tr>
<tr>
<td>
Titile:<font color=red>*</font>
</td>
<td>
<select name=title>
<option value=""> </option>
<option value="Mr.">Mr. </option>
<option value="Ms.">Ms. </option>
</select>
</td>
</tr>
<tr>
<td>
First name:<font color=red>*</font>
</td>
<td>
<input type=text name=fname size=23>
</td>
</tr>
<tr>
<td>
Last name:<font color=red>*</font>
</td>
<td>
<input type=text name=lname size=23>
</td>
</tr>
<tr>
<td>
Date of birth: <font color=red>*</font>
</td>
<td>
<select name=bmonth>
<option value=""> Month </option>
<option value=1> January </option>
<option value=2> February </option>
<option value=3> March </option>
<option value=4> April </option>
<option value=5> May </option>
<option value=6> June </option>
<option value=7> July </option>
<option value=8> August </option>
<option value=9> September </option>
<option value=10> October </option>
<option value=11> November </option>
<option value=12> December </option>
</select>
<select name=bday>
<option value=""> Day </option>
<option value=1> 1 </option>
<option value=2> 2 </option>
<option value=3> 3 </option>
<option value=4> 4 </option>
<option value=5> 5 </option>
<option value=6> 6 </option>
<option value=7> 7 </option>
<option value=8> 8 </option>
<option value=9> 9 </option>
<option value=10> 10 </option>
<option value=11> 11 </option>
<option value=12> 12 </option>
<option value=13> 13 </option>
<option value=14> 14 </option>
<option value=15> 15 </option>
<option value=16> 16 </option>
<option value=17> 17 </option>
<option value=18> 18 </option>
<option value=19> 19 </option>
<option value=20> 20 </option>
<option value=21> 21 </option>
<option value=22> 22 </option>
<option value=23> 23 </option>
<option value=24> 24 </option>
<option value=25> 25 </option>
<option value=26> 26 </option>
<option value=27> 27 </option>
<option value=28> 28 </option>
<option value=29> 29 </option>
<option value=30> 30 </option>
<option value=31> 31 </option>
</select>
<select name=byear>
<option value=""> Year </option>
<option value=1986> 1986 </option>
<option value=1985> 1985 </option>
<option value=1984> 1984 </option>
<option value=1983> 1983 </option>
<option value=1982> 1982 </option>
<option value=1981> 1981 </option>
<option value=1980> 1980 </option>
<option value=1979> 1979 </option>
<option value=1978> 1978 </option>
<option value=1977> 1977 </option>
<option value=1976> 1976 </option>
<option value=1975> 1975 </option>
<option value=1974> 1974 </option>
<option value=1973> 1973 </option>
<option value=1972> 1972 </option>
<option value=1971> 1971 </option>
<option value=1970> 1970 </option>
<option value=1969> 1969 </option>
<option value=1968> 1968 </option>
<option value=1967> 1967 </option>
<option value=1966> 1966 </option>
<option value=1965> 1965 </option>
<option value=1964> 1964 </option>
<option value=1963> 1963 </option>
<option value=1962> 1962 </option>
<option value=1961> 1961 </option>
<option value=1960> 1960 </option>
<option value=1959> 1959 </option>
<option value=1958> 1958 </option>
<option value=1957> 1957 </option>
<option value=1956> 1956 </option>
<option value=1955> 1955 </option>
<option value=1954> 1954 </option>
<option value=1953> 1953 </option>
<option value=1952> 1952 </option>
<option value=1951> 1951 </option>
<option value=1950> 1950 </option>
<option value=1949> 1949 </option>
<option value=1948> 1948 </option>
<option value=1947> 1947 </option>
<option value=1946> 1946 </option>
<option value=1945> 1945 </option>
<option value=1943> 1943 </option>
<option value=1942> 1942 </option>
<option value=1941> 1941 </option>
<option value=1940> 1940 </option>
<option value=1939> 1939 </option>
<option value=1938> 1938 </option>
<option value=1937> 1937 </option>
<option value=1936> 1936 </option>
<option value=1935> 1935 </option>
<option value=1934> 1934 </option>
<option value=1933> 1933 </option>
<option value=1932> 1932 </option>
</select>
</td>
</tr>
<tr>
<td>
Marital Status:
</td>
<td>
<SELECT NAME="maritalstatus">
<OPTION VALUE="Domestic Partner">Domestic Partner</OPTION>
<OPTION VALUE="Engaged">Engaged</OPTION>
<OPTION VALUE="Married">Married</OPTION>
<OPTION VALUE="Separated/Divorced">Separated/Divorced</OPTION>
<OPTION VALUE="Single" selected>Single</OPTION>
<OPTION VALUE="Widowed">Widowed</OPTION>
</SELECT>
</td>
</tr>
<tr>
<td>
Household Income:
</td>
<td>
<SELECT NAME="income" style=width:149>
<OPTION VALUE="1">Under $15,000</OPTION>
<OPTION VALUE="2" selected>$15,000-$29,999</OPTION>
<OPTION VALUE="3">$30,000-$49,999</OPTION>
<OPTION VALUE="4">$50,000 - 74,999</OPTION>
<OPTION VALUE="5">$75,000 - 99,999</OPTION>
<OPTION VALUE="6">$100,000 - 149,999</OPTION>
<OPTION VALUE="7">$150,000 and over</OPTION>
</SELECT>
</td>
</tr>
<tr>
<td>
City:<font color=red>*</font>
</td>
<td>
<input type=text name=city size=33>
</td>
</tr>
<tr>
<td>
State:
</td>
<td>
<select name=state style=width:154>
<OPTION VALUE="Not in US">Not in US</OPTION>
<OPTION VALUE="Alabama">Alabama</OPTION>
<OPTION VALUE="Alaska">Alaska</OPTION>
<OPTION VALUE="Arizona">Arizona</OPTION>
<OPTION VALUE="Arkansas">Arkansas</OPTION>
<OPTION VALUE="California">California</OPTION>
<OPTION VALUE="Colorado">Colorado</OPTION>
<OPTION VALUE="Connecticut">Connecticut</OPTION>
<OPTION VALUE="Delaware">Delaware</OPTION>
<OPTION VALUE="District of Columbia">District of Columbia</OPTION>
<OPTION VALUE="Florida">Florida</OPTION>
<OPTION VALUE="Georgia">Georgia</OPTION>
<OPTION VALUE="Hawaii">Hawaii</OPTION>
<OPTION VALUE="Idaho">Idaho</OPTION>
<OPTION VALUE="Illinois">Illinois</OPTION>
<OPTION VALUE="Indiana">Indiana</OPTION>
<OPTION VALUE="Iowa">Iowa</OPTION>
<OPTION VALUE="Kansas">Kansas</OPTION>
<OPTION VALUE="Kentucky">Kentucky</OPTION>
<OPTION VALUE="Louisiana">Louisiana</OPTION>
<OPTION VALUE="Maine">Maine</OPTION>
<OPTION VALUE="Maryland">Maryland</OPTION>
<OPTION VALUE="Massachusetts">Massachusetts</OPTION>
<OPTION VALUE="Michigan">Michigan</OPTION>
<OPTION VALUE="Minnesota">Minnesota</OPTION>
<OPTION VALUE="Mississippi">Mississippi</OPTION>
<OPTION VALUE="Missouri">Missouri</OPTION>
<OPTION VALUE="Montana">Montana</OPTION>
<OPTION VALUE="Nebraska">Nebraska</OPTION>
<OPTION VALUE="Nevada">Nevada</OPTION>
<OPTION VALUE="New Hampshire">New Hampshire</OPTION>
<OPTION VALUE="New Jersey">New Jersey</OPTION>
<OPTION VALUE="New Mexico">New Mexico</OPTION>
<OPTION VALUE="New York">New York</OPTION>
<OPTION VALUE="North Carolina">North Carolina</OPTION>
<OPTION VALUE="North Dakota">North Dakota</OPTION>
<OPTION VALUE="Ohio">Ohio</OPTION>
<OPTION VALUE="Oklahoma">Oklahoma</OPTION>
<OPTION VALUE="Oregon">Oregon</OPTION>
<OPTION VALUE="Pennsylvania">Pennsylvania</OPTION>
<OPTION VALUE="Puerto Rico">Puerto Rico</OPTION>
<OPTION VALUE="Rhode Island">Rhode Island</OPTION>
<OPTION VALUE="South Carolina">South Carolina</OPTION>
<OPTION VALUE="South Dakota">South Dakota</OPTION>
<OPTION VALUE="Tennessee">Tennessee</OPTION>
<OPTION VALUE="Texas">Texas</OPTION>
<OPTION VALUE="Utah">Utah</OPTION>
<OPTION VALUE="Vermont">Vermont</OPTION>
<OPTION VALUE="Virgin Islands">Virgin Islands</OPTION>
<OPTION VALUE="Virginia">Virginia</OPTION>
<OPTION VALUE="Washington">Washington</OPTION>
<OPTION VALUE="West Virginia">West Virginia</OPTION>
<OPTION VALUE="Wisconsin">Wisconsin</OPTION>
<OPTION VALUE="Wyoming">Wyoming</OPTION>
</select>
</td>
</tr>
<tr>
<td>
Country:<font color=red>*</font>
</td>
<td>
<select name=country>
<OPTION VALUE="">Select</OPTION>
<OPTION VALUE="USA">USA</OPTION>
<OPTION VALUE="Canada">Canada</OPTION>
<OPTION VALUE="UK">UK</OPTION>
</select>
</td>
</tr>
<tr>
<td>
Zip:<font color=red>*</font>
</td>
<td>
<input type=text name=zip size=7>
</td>
</tr>
<tr>
<td>
Address:<font color=red>*</font>
</td>
<td>
<input type=text name=address>
</td>
</tr>
<tr>
<td>
Phone:<font color=red>*</font>
</td>
<td>
<input type=text name=phone>
</td>
</tr>
<tr>
<td>
Phone #2:
</td>
<td>
<input type=text name=phone2>
</td>
</tr>
<tr>
<td>
Email:<font color=red>*</font>
</td>
<td>
<input type=text name=job_seeker_email>
</td>
</tr>
<tr>
<td valign=top>
Job Category:<font color=red>*</font> <br>
</td>
<td valign=top>
<SELECT NAME="JobCategory">
<OPTION VALUE="Trucking Jobs">Trucking Jobs</OPTION>
<OPTION VALUE="Dock Workers">Dock Workers</OPTION>
<OPTION VALUE="LTL Jobs">LTL Jobs</OPTION>
<OPTION VALUE="OTR Jobs">OTR Jobs</OPTION>
<OPTION VALUE="Tanker Jobs">Tanker Jobs</OPTION>
<OPTION VALUE="Dedicated Jobs">Dedicated Jobs</OPTION>
<OPTION VALUE="Regional Jobs">Regional Jobs</OPTION>
<OPTION VALUE="Office Jobs">Office Jobs</OPTION>
<OPTION VALUE="Management Jobs">Management Jobs</OPTION>
<OPTION VALUE="Other Jobs">Other Jobs</OPTION>
<OPTION VALUE="F">Transportation and Warehousing</OPTION>
</SELECT><br>
</td>
</tr>
<tr>
<td>
Your career level:<font color=red>*</font>
</td>
<td>
<select name="careerlevel">
<option value=""> </option>
<OPTION VALUE="1">Student (High School)</OPTION>
<OPTION VALUE="2">Student (undergraduate/graduate)</OPTION>
<OPTION VALUE="3">Entry Level (less than 2 years of experience)</OPTION>
<OPTION VALUE="4">Mid Career (2+ years of experience)</OPTION>
<OPTION VALUE="5">Management (Manager/Director of Staff)</OPTION>
<OPTION VALUE="6">Executive (SVP, EVP, VP)</OPTION>
<OPTION VALUE="7">Senior Executive (President, CEO)</OPTION>
</select>
</td>
</tr>
<tr>
<td>
Target company:
</td>
<td>
<select name="target_company">
<option value=""> </option>
<option value="Small (up to 99 empl.)"> Small (up to 99 empl.) </option>
<option value="Medium (100 - 500 empl.)"> Medium (100 - 500 empl.) </option>
<option value="Large (over 500 empl.)"> Large (over 500 empl.) </option>
</select>
</td>
</tr>
<tr>
<td valign=top>
Willing to relocate?
</td>
<td>
<input type=radio name=relocate value=Yes checked>Yes<br>
<input type=radio name=relocate value=No>No
</td>
</tr>
<tr>
<td align=left>ย </td>
<td align=center>
<input class=s2 type=submit name=submit value="Register me" align=left>
<input class=s2 type=reset name=reset value="Reset" align=right>
</td>
</tr>
</table>
</form>
<? include_once('../foother.html'); ?>
oh, I don't expect this to be done for free but I do expect it to be done right.
Thanks







